Abstract

Osteoarthritis (OA) is a degenerative joint disease characterized by progressive loss
of articular cartilage, subchondral bone sclerosis, osteophyte formation, and synovial
inflammation, causing substantial physical disability, impaired quality of life, and
significant health care utilization. Traditionally, non-steroidal anti-inflammatory
drugs (NSAIDs), including selective cyclooxygenase (COX)-2 inhibitors, have been used
to treat pain and inflammation in OA. Besides its anti-inflammatory properties, evidence
is accumulating that celecoxib, one of the selective COX-2 inhibitors, has additional
disease-modifying effects. Celecoxib was shown to affect all structures involved in
OA pathogenesis: cartilage, bone, and synovium. As well as COX-2 inhibition, evidence
indicates that celecoxib also modulates COX-2-independent signal transduction pathways.
These findings raise the question of whether celecoxib, and potentially other coxibs,
is more than just an anti-inflammatory and analgesic drug. Can celecoxib be considered
a disease-modifying osteoarthritic drug? In this review, these direct effects of celecoxib
on cartilage, bone, and synoviocytes in OA treatment are discussed.